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3. Experiences in Patent Ductus Arteriosus Closure of Preterm Infants Transported to Another Center for Surgical Ligation.

Author

Dedeoğlu, Savaş and Şaşmazel, Ahmet

Subjects
*STATISTICS, *PATENT ductus arteriosus, *INTRACRANIAL hemorrhage, *RETROSPECTIVE studies, *MANN Whitney U Test, *TREATMENT effectiveness, *ARTIFICIAL respiration, *SEPSIS, *T-test (Statistics), *PEARSON correlation (Statistics), *COMPARATIVE studies, *HOSPITAL care, *BIRTH weight, *DESCRIPTIVE statistics, *CHI-squared test, *BRONCHOPULMONARY dysplasia, *DATA analysis software, *DATA analysis, *LIGATURE (Surgery)
Abstract

Objective: The timing of surgical patent ductus arteriosus ligation in preterm infants remains controversial. Early ligation (<2 or 3 weeks of life) benefits preterm infants with a lower incidence of bronchopulmonary dysplasia and necrotizing enterocolitis. We present patent ductus arteriosus ligation experience in premature infants who had been transported for closure to an outside centre other than the hospital they were hospitalized. Materials and Methods: We retrospectively evaluated 17 consecutive patients who had undergone surgery of premature infant patent ductus arteriosus closure during the period of March 2009-December 2020. Patent ductus arteriosus had been clipped in 17 patients. Results: The median birth weight and age were 930 g and 28 gestation weeks, respectively. The birth age of the sub-groups were A: ≤28 weeks and B: >28 weeks and birthweight were group I: ≤800 g and group II: >800 g. The median day of PDA ligation wasa 20 days, and patients with birthweight ≤800 g were ligated later than patients weighing >800 g. Two patients had intracranial hemorrhage, 6 had bronchopulmonary dysplasia, and 2 were dead. We found that exposure to large patent ductus arteriosus and low birth age in preterm babies was associated with longer hospitalization duration, preoperative mechanical ventilation time, and sepsis. Conclusion: Infants exposed to moderate-to-large patent ductus arteriosus requiring intubation and resistant to medical therapy for more than 2 weeks should have surgical ligation as soon as possible. [ABSTRACT FROM AUTHOR]

Published
2023
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7. Comparison of cases with and without additional lower body perfusion in newborns undergoing aortic arch reconstruction with antegrade selective cerebral perfusion method

Author

Kılıç, Yiğit, primary, Selçuk, Arif, additional, Korun, Oktay, additional, Ceyda, Hasan, additional, Çiçek, Murat, additional, Yurdakök, Okan, additional, Altın, Fırat, additional, Erdem, Hasan, additional, Ali Aydemir, Numan, additional, and Şaşmazel, Ahmet, additional

Published
2022
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9. Comparison of Doty and McGoon techniques for surgical reconstruction of congenital supravalvular aortic stenosis

Author

Biçer, Mehmet, primary, Dedemoğlu, Mehmet, additional, Korun, Oktay, additional, Altın, Hüsnü F., additional, Yurdakök, Okan, additional, Çiçek, Murat, additional, Özdemir, Fatih, additional, Selçuk, Arif, additional, Altuntaş, Yasemin, additional, Yücel, Ilker K., additional, Şaşmazel, Ahmet, additional, and Aydemir, Numan A., additional

Published
2021
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18. Istanbul Symposium on Neonatal and Pediatric Cardiopulmonary Bypass Procedures

Author

Ündar, Akif, Alkan-Bozkaya, Tijen, Palanzo, David, Ersayin-Kantas, Huriyet, Chin, Chris, Ödemiş, Ender, Pekkan, Kerem, Ağirbaşli, Mehmet A., Türköz, Ayda, Türköz, Rza, Haydin, Sertaç, Erek, Ersin, Yalçnbaş, Yusuf K., Şaşmazel, Ahmet, Karac, Ali Rza, Erkan, Halime, Çicek, Ali Ekber, Bakr, İhsan, Saroğlu, Tayyar, Akçevin, Atf, and Aytaç, Aydn

Published
2012
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22. Modified Closed Coronary Transfer is a Good Alternative to the Trap-Door Method During Arterial Switch Operation: a Retrospective Propensity-Matched Comparison

Author

Dedemoğlu, Mehmet, primary, Coşkun, Gültekin, additional, Özdemir, Fatih, additional, Yurdakök, Okan, additional, Korun, Oktay, additional, Çiçek, Murat, additional, Biçer, Mehmet, additional, Coşkun, Filiz İzgi, additional, Ali Aydemir, Numan, additional, and Şaşmazel, Ahmet, additional

Published
2020
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24. A Rare Complication of Infective Endocarditis

Author

ŞAHİN, İrfan Oğuz, ŞAŞMAZEL, Ahmet, GÜRSU, Hazım Alper, CEYLAN, Özgür, BİÇER, Mehmet, KAYA, Ali, DURAN, Fatih, and Sivas Cumhuriyet Üniversitesi

Subjects
Atriyoventriküler blok,Çocuk,Enfektif endokardit, Atrioventricular block,Child,Infective endocarditis, Pediatri
Abstract

Tam atriyoventriküler blok (AVB) enfektif endokarditin (EE) iyi tanımlanmış ancak nadir bir komplikasyonudur. Atriyoventriküler blok derecesi enfeksiyonun yayılımını yansıtır. Bu yüzden AVB derecesinin artmış morbidite ve mortalite ile ilişkili olduğu düşünülmektedir. Yeni gelişen AVB'nin EE göstergesi olarak değerlendirilmesi ve tanı koyulduktan sonra EE'nin mümkün olduğunca çabuk tedavi edilmesi önerilmektedir. Burada, erken dönemde 1.derece AVB olup uygun tedavi başlanana dek 3.derece AVB ortaya çıkan aort kapak endokarditli bir hasta sunulacaktır. Başarılı cerrahi girişim ve uygun antibiyotik tedavisi sonrasında AVB hiçbir komplikasyon olmaksızın düzelmiştir., Complete atrioventricular block (AVB) is one of the well described but uncommon complications of infective endocarditis (IE). The degree of AVB reflects the extension of infection. The degree of AVB is thought to be associated with increased morbidity and mortality. It is recommended to evaluate newly developed AVBs as predictors of IE, to diagnose and treat IE as soon as possible. We report a case with delayed diagnosis of aortic valve endocarditis that revealed first degree AVB in the earlier phase of disease and followed by complete AVB until accurate treatment was started. Successful surgical intervention and antibiotherapy resulted in a downgrading and diminishing of the high-grade conduction block without any complications.

Published
2018

25. Aortic translocation procedure: Early outcomes from a single center

Author

Korun, Oktay, primary, Yurdakök, Okan, additional, Çiçek, Murat, additional, Altın, Fırat Hüsnü, additional, Selçuk, Arif, additional, Kılıç, Yiğit, additional, Kudsioğlu, Şefika Türkan, additional, Bulut, Mustafa Orhan, additional, Erdem, Hasan, additional, Aydemir, Numan Ali, additional, and Şaşmazel, Ahmet, additional

Published
2019
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28. Anomalous left coronary artery from the pulmonary artery repair outcomes: Preoperative mitral regurgitation persists in the follow‐up.

Author

Biçer, Mehmet, Korun, Oktay, Yurdakök, Okan, Çiçek, Murat, Dedemoğlu, Mehmet, Özdemir, Fatih, Kılıç, Yiğit, Altın, Hüsnü F., Şaşmazel, Ahmet, and Aydemir, Numan A.

Subjects
PULMONARY artery, MITRAL valve insufficiency, CORONARY arteries, CORONARY artery bypass, REIMPLANTATION (Surgery), PULMONARY stenosis
Abstract

Objective: This study aims to present the midterm outcomes of surgical correction of the anomalous left coronary artery from the pulmonary artery (ALCAPA) with a focus on mitral regurgitation (MR). Methods: Medical records of 36 ALCAPA patients who underwent surgery in a single center were retrospectively reviewed. Results: There were one (2.7%) neonate, 19 (52.7%) infants, 15 (41.6%) children, and 1 (2.7%) adult patient operated. Coronary reimplantation, tube reconstruction, and coronary artery bypass surgery techniques were performed in 29 (80.5%), 6 (16.6%), and 1 (2.7%) patient, respectively. Sixteen (44.4%) patients had a low ejection fraction and 13 (36.1%) patients had at least moderate MR preoperatively. None of our patients underwent a concomitant mitral surgery during the initial repair. Three and two patients died in the early and late postoperative period, respectively. Two patients underwent reoperation due to MR and pulmonary stenosis, separately. Preoperative MR was the only factor associated with at least moderate MR at the final follow‐up (p <.01) and the presence of preoperative moderate or over‐moderate MR estimated at least moderate MR at the final follow‐up with 100% sensitivity and 80% specificity. Conclusion: Although the mitral valve was not repaired in the first operation, the reoperation rate is low. However, a moderate or higher preoperative MR predicted MR at the last follow‐up. Performing annuloplasty in such patients can be a strategy to be researched. [ABSTRACT FROM AUTHOR]

Published
2021
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29. Aortic arch and intracardiac repair without circulatory arrest in neonates and infants

Author

Karacı, Ali Rıza, Şaşmazel, Ahmet, Dedeoğlu, Reyhan, Aydemir, Numan Ali, Harmandar, Buğra, Erdem, Hasan, Cengiz, Dicle, and Bölüm Yok

Subjects
Pulmonary and Respiratory Medicine, Gynecology, Aortic arch, medicine.medical_specialty, business.industry, Aortic arch intracardiac surgery, medicine.disease, Body weight, Intracardiac injection, Aortopulmonary window, Double outlet right ventricle, Great arteries, medicine.artery, Antegrade cerebral perfusion, Circulatory system, cardiovascular system, Neonatal infant, medicine, Cardiac defects, Surgery, Cardiology and Cardiovascular Medicine, business
Abstract

Amac: Bu yazida yenidogan ve infantlarda aortik arkus ve intrakardiyak tamir ile birlikte, selektif antegrad serebral perfuzyon ile yapilan cerrahi deneyimimiz bildirildi. Ca­lis­ma­pla­ni:­Mart 2007 Nisan 2012 tarihleri arasinda arkus aort ve intrakardiyak tamiri uygulanan 27 ardisik hastanin (18 erkek, 9 kiz; ort. yas 9.9+1.7 gun, dagilim 1-26 gun) tibbi verileri retrospektif olarak incelendi. Ameliyat sirasi risk faktorleri ve ameliyat sonrasi 30 gunluk mortalite arasindaki iliski incelendi. Bul gu lar: Hastalarin ortalama vucut agirligi 3.2±0.9 kg idi. On iki hastada major kardiyak defekt vardi ve bunlar trunkus arteriozus (Vaan Pragh tip 4) (n=2), buyuk arterlerin transpozisyonu (n=5), cift cikisli sag ventrikulde Taussing Bing anomalisi (n=2) ve aortopulmoner pencere defekti (n=3) idi. Bobrek yetmezligi ve diyaliz ile mortalite arasinda istatistiksel olarak anlamli bir iliski bulundu [Ki kare, sirasiyla 27 (p=0.000) ve 20.66 (p=0.000)]. So­nuc:­ Yenidoganlarda ve infantlarda, intrakardiyak cerrahi tamir ile es zamanli arkus aort tamiri, tek asamali selektif antegrad serebral perfuzyon ile yapilabilir. Anah tar soz cuk ler: Antegrad serebral perfuzyon; arkus aort intrakardiyak cerrahi; yenidogan bebek. Background:­ In this article, we aimed to report our surgical experiences with selective antegrade cerebral perfusion combined with the aortic arch and intracardiac surgery in neonates and infants. Methods: Medical data of 27 consecutive patients (18 boys, 9 girls; mean age 9.9+1.7 days; range 1 to 26 days) who undergoing aortic arch and intracardiac repair between March 2007 and April 2012 were retrospectively analyzed. The link between perioperative risk factors and 30-day mortality following surgery were investigated. Results:­The mean body weight of patients were 3.2±0.9 kg. Major associated cardiac defects were present in 12 and included truncus arteriosus (Vaan Pragh type 4) (n=2), transposition of the great arteries (n=5), double outlet right ventricle with Taussing Bing anomaly (n=2), and aortopulmonary window defect (n=3). Renal insufficiency and dialysis were statistically significantly associated with mortality [Chi square 27 (p=0.000) and 20.66 (p=0.000), respectively]. Conclusion:­ Aortic arch repair with simultaneous intracardiac surgical repair can be done with selective antegrade cerebral perfusion at a single stage in neonates and infants.

Published
2014

30. A Rare Cardiac Tumor in Childhood

Author

Elevli, Murat, primary, Şaşmazel, Ahmet, additional, Çivilibal, Mahmut, additional, Şahin, Musa, additional, Amed, Chousen, additional, and Kılınç, Emine, additional

Published
2017
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31. Resection End To End Anastomosis, Subclavian Flap Aortoplasty And Modifed Subclavian Aortoplasty Surgical Techniques of the Aortic Coarctation Compared by The Insidancy Of Recoartation

Author

Şaşmazel, Ahmet, Paker, Tufan, Akçevin, Atıf, Türko¤lu, Halil, Sar›o¤lu, Tayyar, and Aytaç, Ayd›n

Subjects
Health Care Sciences and Services, cardiovascular system, Aortic coartation,surgical techniques,recoarctation, Sağlık Bilimleri ve Hizmetleri, Aort koarktasyonu,cerrahi teknikler,rekoarktasyon
Abstract

Resection End To End Anastomosis, Subclavian Flap Aortoplasty And Modifed Subclavian Aortoplasty Surgical Techniques of the Aortic Coarctation Compared by The Insidancy Of Recoartation We try to evaluate the incidence of recoarctation after the surgical repair techniques for aortic coarctation in two group of patients ages between 0-3 months and 3–24 months. These techniques are resection end to end anastomosis, subclavian flap aortoplasty and modified subclavian aortoplasty. We aim to figure out which operation appears to have a clear superiority according to the age groups. From June, 1987, to December, 1999, a consecutive series of 72 patients less than 2 year of age were referred to our clinic for aortic coarctation repair. Patients diveded into two groups by means of their ages. The group 1; ages were between 0–3 months, group 2; ages were between 3–24 months old. The surgical techniques were resection end to end anastomosis, subclavian flap aortoplasty and modified subclavian aortoplasty. The patients were evaluated according to their ages, coarctation gradient and reoperations depending on the surgical techniques that was done before.We lost 4 patient in group 1 at the early period of the operations. These patients had severe congestive heart failure and complex cardiac pathologies prior to the operations Recoarctation was occurred in 4 patients in group 1. 3 of these patient had subclavian flap aortoplasty and one had resection end to end anastomosis before. All 3 recoarctation cases were successfully treated by surgery. One patient had a balloon angioplasty. Recoarctation occurred in 1 patient in group 2 ( below the age 24 months). This patient operated by the surgical technique of resection end to end anastomosis and thereafter successfully treated by balloon angioplasty. According to our surgical experiences resection end to end anastomosis can be safely performed below the age of 3 months. For surgical necessities subclavian flap aortoplasty and modified subclavian aortoplasty are admirable for relief of the coarctation in infants with low recurrence rates and acceptable operative and intermediate survival. But the subclavian flap should be extended distally over the coarctated segment., Bu yazmzda, 0–3 ay ve 3–24 ay arasndaki aort koarktasyonlu hasta gruplarnda, rezeksiyon uçuca anastomoz, subklavyan flap aortoplasti ve modifiye subklavyan aortoplasti tekniklerinin geç postoperatif dönemde rekoarktasyon yönünden birbirleriyle karfllafltrmak ve hangi prosedürün yafl gurubuna göre daha uygun oldu¤unu belirlemeyi amaçladk. Haziran 1987 - Aralk 1999 tarihleri arasnda aort koarktasyonu tans nedeniyle opere edilen, 2 yafl altnda toplam 77 hasta çalflmaya alnd. Hastalar iki grupta topland. Grup 1, 0–3 ay aras olup, grup 2 ise 3–24 ay aras opere edilen hastalar idi. Cerrahi prosedür olarak, rezeksiyon uç uca anastomoz, subklavian flap aortoplasti ve modifiye subklavyan aortoplasti teknikleri kullanld. Uygulanan cerrahi tekni¤ine göre hastalar yafl, postoperatif dönemde koarktasyon bölgesinden elde edilen basnç gradiyentlerine, reoperasyona göre karfllafltrld. Grup 1'de, 4 hastamz postoperatif dönemde kaybettik. Bu hastalarn preoperatif dönemde ileri derece kalp yetersizli¤ i bulgular ve kompleks kalp patolojileri olan hastalard. Grup'1 de, 4(%12) hastada rekoarktasyon görüldü. 3 hastaya subklavyan flap angioplasti 1 hastaya da, reseksiyon uç uca anastomoz cerrahi teknikleri uygulanmflt. 3 hasta rekoarktasyon nedeniyle ameliyata alnd. 1 hastann ise koarktasyonu balon anjioplasti ile geniflletildi. Grup 2'de mortaliteye rastlanmad. Fakat ancak Grup 2'de reseksiyon uç uca anastomoz sonras 1 hastada rekoarktasyon görüldü ve balon anjioplasti ile geniflletildi. Çalflmamzn sonucuna göre 3 ay alt çocuklarda reseksiyon uç uca anastomoz tekni¤i güvenilir bir cerrahi prosedürdür. Cerrahi yönden gerekli oldu¤u durumlarda e¤er subklavyan flap veya modifiye subklavyan aortoplasti tekni¤ i kullanlacaksa flap mümkün oldu¤unca kaorkte segmentin distaline kadar uzatlmaldr.

Published
2015

32. Radial Artery Aneurysm

Author

Buğra, Onursal, Fedakar, Ali, Şaşmazel, Ahmet, and Fındık, Orhan

Subjects
Radial artery,aneurysm, Radial arter,anevrizma
Abstract

Üst ekstremite arter anevrizmaları diğer periferik arter anevrizmalarına göre daha nadir görülürler. Radial arter anevrizmalarının genellikle travmatik orijinli olduğu bildirilmektedir. Radial arter düzeyinde gelişen psödoanevrizmalar sıklıkla invazif girişimlerden sonra görülürler. Distalde ve özellikle radial arter düzeyinde yerleşmiş arter anevrizmalarının el ve parmaklarda tromboembolik komplikasyonlara neden olduğu bildirilmiştir. Bu yazıda idiopatik izole radial arter anevrizması olgumuzu sunmayı amaçladık., Upper limb aneurysms are less frequently seen than the other aneurysm. Radial arterial aneurysm is usually associated with the trauma. Interventional procedures can cause pseudoaneurysm at the radial artery puncture sites. Radial artery aneurysm may cause the thromboembolic events at the fingers and the hand. We present a case of isolated radial arterial aneurysm with idiopathic origin.

Published
2015

33. Fallot Tetrolojisinde Koroner Arter Anevrizmas› ve Koroner Fistul: Tam Düzeltme Yap›lan Genç Eriflkin Bir Vaka Sunumu

Author

Fedakar, Ali, Şaşmazel, Ahmet, Bugra, Onursal, Boyac›o¤lu, Kamil, Baysal, Ayfle, İnci, Ayfle, and Balkanay, Mehmet

Subjects
Fallot tetralojisi, koroner arter, anevrizma, koroner fistül, Coronary artery, aneurysm, coronary fistula
Abstract

Congenital presentation of a coronary artery fistula is a rarely observed pathologic finding; especially an association with tetralogy of Fallot is reported in only three cases previously. This is a presentation of a patient with tetralogy of Fallot who had an aneurysmatic fistula communication between the circumflex artery and left ventricle. Preoperative computerized tomography angiographic examination showed a communication between the circumflex artery and left ventricle. 27-year-old female patient underwent an operation for total correction. Intraoperatively, the fistula could not be seen and it had been left unligated. The patient had been discharged from hospital without problems on the tenth postoperative day. Aneurysmatic coronary artery fistula is not found to cause a deleterious effect on the hemodynamics or myocardial performance of the heart after the total correction surgery, Konjenital koroner arter fistülü oldukça nadir gözlenen bir patolojik bulgudur. Özellikle Fallot tetralojisi ile birlikteli¤ i ise daha önce sadece üç vaka olarak rapor edilmifltir. Bu yaz›m›zda sircumflex arter ile sol ventrikül aras›nda fistül bulunan fallot tetrolojili bir hastan›n sunumu yap›lmaktad›r. Ameliyat öncesi bilgisayarl› tomografik anjiografide sol ventrikül ile sircumflex arter aras›nda anevrizmatik fistül iliflkisi gözlemlendi. 27 yafl›ndaki bayan hasta tam düzeltme ameliyat›na al›nd›. Operasyonda fistül bulunamad› ve ba¤lanmadan b›rak›ld›. Problemi olmayan hasta, ameliyat sonras› onuncu günde taburcu edildi. Anevrizmatik koroner arter fistülün tam düzeltme ameliyat› sonras› nda miyokardiyal performansda ve hemodinamide bozulma yaratan bir etkisi gözlemlenmedi.

Published
2015

34. Intraoperative Flow Study Predicted the Postoperative Pulmonary Artery Pressure in the Bidirectional Glenn Operation

Author

Korun, Oktay, Yücel, İlker Kemal, Çiçek, Murat, Altın, Hüsnü Fırat, Yurdakök, Okan, Kılıç, Yiğit, Selçuk, Arif, Yurtseven, Nurgül, Şaşmazel, Ahmet, and Aydemir, Numan Ali

Abstract

Background: The aim of this study was to evaluate the predictability of postoperative pulmonary artery pressure (PAP) using intraoperative flow study in patients undergoing bidirectional Glenn operation.Methods: Patients who underwent Glenn operation under cardiopulmonary bypass (CPB) were included in the study. During the operation, after the completion of additional procedures under CPB, an intraoperative flow study was performed prior to Glenn anastomosis. After the completion of bidirectional Glenn, the patient was separated from the CPB and PAP was measured. The relationship between this pressure and flow study measurement was analyzed.Results: Nine patients who underwent bidirectional Glenn operation with additional procedures under CPB between July 2018 and January 2019 were included in the study. The median PAP was 9 mm Hg (interquartile range [IQR]: 7-10 mm Hg) in the flow study and 10 mm Hg (IQR: 8-11 mm Hg) after CPB, and the median difference between these pressures was 1 mm Hg (IQR: 1-3 mm Hg). There was a strong correlation between these two measurements (r= 0.732; P= .025).Conclusion: The results of this study show that PAP after the Glenn procedure can be estimated using an intraoperative flow study. We believe that this method may be useful in intraoperative decision-making for Glenn operation in single ventricular patients who require extensive pulmonary artery (PA) reconstruction due to limited PA development, branch PA stenosis, or nonconfluent PAs. Also, this method can be used as a sort of intraoperative pulmonary resistance reversibility study in patients with high preoperative pulmonary vascular resistance due to surgically correctable pulmonary venous hypertension.

Published
2020
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35. Midline one-stage complete unifocalization early outcomes from a single center.

Author

Korun, Oktay, Yurdakök, Okan, Dedemoğlu, Mehmet, Yücel, İlker Kemal, Çelebi, Ahmet, Kudsioğlu, Şefika Türkan, Şaşmazel, Ahmet, and Aydemir, Numan Ali

Subjects
VENTRICULAR septal defects, PULMONARY atresia, HOSPITAL mortality, OPERATIVE surgery
Abstract

Objective: This study aims to present our experience with single-stage complete unifocalization and intraoperative flow study for the repair of ventricular septal defect, pulmonary atresia, and major aortopulmonary collateral arteries. Methods: This study was conducted through retrospective chart review of all the patients who underwent complete single-stage midline unifocalization in a single tertiary-care institution. Results: Twenty-two patients underwent midline single-stage unifocalization. The median age was 11 months (IQR: 5-21 months). The number of collateral arteries unifocalized was between one and three (median two). In-hospital mortality was 5%. Follow-up was complete; and the median follow-up regarding survival was 20 months (IQR: 10-28 months). There were three late deaths, and the estimated survival rate was 80% at 10 months and on. Out of 22 patients, ventricular septal defect was closed in the first surgery in three patients (14%) and the second surgery in four patients (19%). Total seven patients underwent surgical total repair (32%). Additionally, one out of four patients whose ventricular septal defects were closed with a fenestrated patch is under follow-up with a small ventricular septal defect, while two are waiting for ventricular septal defect closure. Therefore, total eight patients (36%) have reached total correction. Conclusion: Single-stage unifocalization is a feasible treatment option in ventricular septal defect, pulmonary atresia, and major aortopulmonary collateral arteries. This cohort had unfavorable results regarding the rate of complete repair. The pitfalls encountered were related to problems with meticulous surgical technique, complete unifocalization, and correct implementation of the flow study. [ABSTRACT FROM AUTHOR]

Published
2019
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36. Ross operation early and mid-term results in children and young adults.

Author

Korun, Oktay, Selçuk, Arif, Yurdakök, Okan, Altın, Hüsnü Fırat, Çiçek, Murat, Kılıç, Yiğit, Kudsioğlu, Şefika Türkan, Bulut, Mustafa Orhan, Aydemir, Numan Ali, and Şaşmazel, Ahmet

Subjects
YOUNG adults, ADULT-child relationships, INFECTIVE endocarditis, VENTRICULAR outflow obstruction
Abstract

Objective: The Ross procedure has been cited as the procedure of choice for young patients requiring aortic valve replacement. However, potential for reintervention requirement in both left and right ventricular outflow tracts can be a source of concern. The aim of the present study was to describe our experience with this procedure. Methods: A retrospective chart review of all the patients who underwent the Ross procedure in a single institution was performed. National death registry records were used for late mortality. Results: Eighteen Ross procedures between May 2003 and May 2018 were performed. The median age of the cohort was 15 [interquartile range (IQR): 12-18] years. The pulmonic conduit was a homograft in 11 patients, Labcor in 5 patients, Contegra in 1 patient, and Medtronic Freestyle Valve in 1 patient. There were three early deaths. The median follow-up of 15 hospital survivors was 11 (IQR: 3-14) years. Any late mortality was not observed. In the two surviving patients with infective endocarditis, there was no recurrent infective endocarditis. Freedom from reintervention was 80% at 8 years and onward. Any risk factors associated with reintervention could not be identified. However, freedom from autograft dilatation at 10 years was 45%. Conclusion: Autograft failure is a potential problem in the long-term follow-up of Ross patients. Freedom from reintervention was satisfactory, and the type of pulmonic conduit did not affect the mid-term outcomes. In patients with infective endocarditis, the Ross procedure has a low recurrence rate, but it might have an increased risk of mortality. [ABSTRACT FROM AUTHOR]

Published
2019
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38. Uluslararası öğrenci değerlendirme programı (PISA)'nda Türk öğrencilerin fen bilgisi başarılarını etkileyen faktörler

Author

Şaşmazel, Ahmet Gökhan, Gelbal, Selahattin, and Diğer

Subjects
Eğitim ve Öğretim, Education and Training
Abstract

Bu araştırmada, 15 yaşındaki öğrencilere PİS A (Uluslararası Öğrenci Değerlendirme Programı) Projesi kapsamında uygulanan anket verilerinin fen bilimleri okur-yazarlığı başarısını yordama gücüne bakılmıştır. Başarıyı etkileyen değişkenler araştırmacı tarafından üç alt problemde incelenmiştir. `Ailenin sosyo-ekonomik durumu; öğrencinin okula, öğretmenlere ve geleceğe karşı anketteki sorular ile ölçülen görüşleri ve öğrenci özellikleri; bilgisayar kullanabilme becerileri ve bilgisayara karşı tutumu.` her problem için proje kapsamında hazırlanan anket sorularından uzmanlarca derlenmiş indeksler ve indekslere girmemiş baza anket sorulan kullanılmıştır. Evren katılan ülkelerdeki 15 yıl 3 ay ve 16 yıl 2 ay yaş aralığındaki tüm öğrencilerdir. Türkiye'den uygulamaya 2090 kız, 2765 erkek öğrenci olmak üzere toplam 4855 öğrenci katılmıştır. Birinci alt problem (Ailenin sosyo-ekonomik durumu ve fen bilgisi başarısı) için yapılan çoklu regresyon analizi beş adımda sonlanmıştır. `Evdeki kitap sayısı` bu analizde en güçlü yordayıcı değişkendir. İkinci alt problem (Öğrencinin okula, öğretmenlere ve geleceğe karşı tutumu ve öğrenci özellikleri ve fen bilgisi başansı) için yapılan çoklu regresyon analizi sekiz adımda sonlanmıştır. `Evdeki eğitimsel kaynaklar indeksi` bu analizde en güçlü yordayıcı değişkendir. Üçüncü alt problem (Bilgisayar kullanabilme becerileri ve bilgisayara karşı tutumu, ve fen bilgisi başarısı) için yapılan çoklu regresyon analizi sekiz adımda sonlanmıştır.`Bilgisayarda sıradan işlerde kendine güven indeksi` bu analizde en güçlü yordayıcı değişkendir. Araştırma sonucunda öğrencilere kitap okuma alışkanlığı kazandırılması, bilgisayarın eğitim hedeflerine hizmet edecek şekilde öğrenciye sunulması, aile, okul ve öğrenci arasındaki iletişimin artırılması önerilmiştir. In this study the purpose is to exarnine the factors that are affect success of scientific literacy on 15-year old students in Turkey by the Programme for International Student Assessment (PISA) data. Those factors affect success examined by three sub problems by researcher. `First of them is socioeconomic status of family, second one is student's attitudes; towards school, teachers and future, than last one is student skills; computer usage, attitudes towards computers.'' For each problem, indexes that collected from project questionnaire by experts and some questions didn't take place in indexes are used. Population is all students of participant countries which are between 15, 3 months and 16 year 2 months old students. Turkey attended this program by 2090 girl, 2765 boy totally 4855 students. Multi regression analyze made for the first sub-problem (parents socioeconomic status and success on natural sciences) included five steps. `Number of books at home` was the best testing variable in this problem. Multi regression analyze made for the second sub-problem (second student's attitudes; towards school, teachers and future and success on natural sciences) included eight steps. `Index of educational sources at house` was the best testing variable in this problem. Multi regression analyze made for the third sub-problem (student skills; computer usage, attitudes towards computer and success on natural sciences) included eight steps.VI `Index of self confidence while doing usual works on computer` was the best testing variable in this problem. As the result of research; increase book reading habits of students, computer usage should be served to students by the means of education aims, much more communication between parents, students and school suggested. 80

Published
2006

45. Çocukluk Çağında Ender Görülen Bir Kardiyak Tümör.

Author

Elevli, Murat, Şaşmazel, Ahmet, Çivilibal, Mahmut, Çelebi, Ahmet, Şahin, Musa, Amed, Chousen, and Kılınç, Emine

Subjects
*MYXOMA, *RIGHT heart ventricle, *HEART tumors, *DISEASE prevalence, *DIAGNOSIS
Abstract

The prevalence of primary cardiac tumors has been reported to be between 0.19% and 0.0017%. Cardiac tumors are usually intracavitary lesions and more than 75% of them are benign. Myxomas are rare in childhood and constitute 10% of all pediatric cardiac tumors. Myxomas localized in the right ventricle are very rare in children. In this paper, we describe a 14-year-old boy with right ventricular myxoma. [ABSTRACT FROM AUTHOR]

Published
2017
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46. Prognostic significance of sICAM-1 and sVCAM-1 molecules for cardiac surgery in pediatric patients with pulmonary hypertension.

Author

Yıldırım, Ayşe, Güzelmeriç, Füsun, Öner, C. Naci, Karaağaç, Aysu Türkmen, Şaşmazel, Ahmet, Erdem, Hasan, Özdemir, Osman, and Baysal, Ayşe

Subjects
CELL adhesion, CARDIAC surgery, PULMONARY hypertension, BLOOD testing, CONGENITAL heart disease, BIOMARKERS, PROGNOSTIC tests, HEALTH outcome assessment, PATIENTS
Abstract

Objective: To investigate preoperative and postoperative blood levels of soluble intercellular and vascular cell adhesion molecules (sICAM-1, sVCAM-1) in patients with and without pulmonary hypertension (PAH) due to congenital heart disease and left to right (L-R) shunt and to determine whether these molecules can be used as reliable prognostic markers of endothelial activity to predict surgical outcomes. Methods: In this observational prospective cohort study; 42 patients, operated for L-R shunt were divided into three groups. Group 1: L-R shunt without PAH, Group 2: L-R shunt with PAH, Group 3: L-R shunt with PAH and postoperative low cardiac output syndrome (LCOS). Their sICAM-1 and sVCAM-1 levels were measured preoperatively (sICAM-0, sVCAM-0) and on the first (sICAM-1, sVCAM-1) and fifth postoperative days (sICAM-2, sVCAM-2).ROC curve for various cut-off levels of sICAM 0, sVCAM 0 in differentiating PAH patients with and without LCOS. Results: In Group 3, sICAM-0 and sVCAM-2 levels were higher than Group 1 and 2. The ROC curve demonstrated a significant association between sICAM-0 in patients with L-R shunt and PAH (Group 2 and 3) and the development of LCOS (area under the curve: 0.98, p<0.01 and 0.97, p<0.01, respectively). At a sICAM 0 concentration >359 ng/mL, there was a sensitivity of 90% and specificity of 95% for identification of LCOS in patients with L-R shunt and PAH (AUC: 0.98, 95% CI: 0.95-1.02, p<0.01). Conclusion: High preoperative sICAM-1 molecule may be used to predict postoperative dichotomous outcome in patients with PAH associated with L-R shunt. [ABSTRACT FROM AUTHOR]

Published
2014
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47. Fallot tetralojili on iki ay altı infantlar ile bir-dört yaş arası çocuk hasta gruplarında tam düzeltme ameliyatı sonrasında kısa dönem mortalite ve morbiditenin belirleyicileri.

Author

Şaşmazel, Ahmet, Fedakar, Ali, Baysal, Ayşe, Çalışkan, Ahmet, Buğra, Onursal, and Sunar, Hasan

Subjects
*TETRALOGY of Fallot, *CONGENITAL heart disease, *CHILD mortality, *QUANTITATIVE research, *PREDICTION models, MORTALITY risk factors
Abstract

Objective: In patients with tetralogy of Fallot, infants less than 12 months old and children between one and four years old were compared after total repair surgery for determination of outcome of surgery, risk factors influencing mortality and morbidity. Methods: Fifty- two patients with tetralogy of Fallot between five months and four years of ages were included into the study. The patients were divided into two groups depending on their ages; Group 1; one year old and younger (n=21) whereas, group 2; one and four years old (n=31). Statistical analysis was performed using Mann-Whitney U, Chi-square or where appropriate Fisher's exact tests and logistic regression analysis was applied for determination of predictors of mortality. Results: The parameters that were different between two groups include; age (Group 1; 10.00±1.67 months and Group 2; 2.39±0.77 years, p<0.001), weight (Group 1; 9.74±2.23 kg, Group 2; 11.97±1.78 kg, p<0.001), McGoon ratio (Group 1; 1.94±0.29, Group 2; 2.19±0.27, p=0.001). Mortality is found in 3 patients in group 1 (14.2%) whereas, in five patients in group 2 (16%) and the difference was not statistically significant. In group 2 in only one patient (0.03%) had complete atrioventricular block and required permanent pacemaker implantation. When patients were compared according to groups with and without mortality, the significant differences were found in following variables: peritoneal dialysis (p=0.001), pleural effusion (p=0.02), right ventricular pressure (p=0.001) and right ventricle/aorta pressures ratio (p=0.001). However, none of these risk factors had significant value in prediction of mortality. Conclusion: Depending on these results, in patients under one year of age with symptomatic tetralogy of Fallot, if there are no other pathologies that have potential to increase risk of mortality, the complete repair surgery can be performed with same amount of risks and similar morbidity and mortality ratios. [ABSTRACT FROM AUTHOR]

Published
2010
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